The present invention relates to beds and stretchers in general and more particularly to such used to accommodate patients in intensive or cardiac care units in hospitals.
Most well equipped modern hospitals have intensive care units and/or cardiac care units (hereafter collectively referred-to only as intensive care units) for the treatment of patients requiring constant care and monitoring. Although originally used primarily for victims of heart attack and similar life-threatening heart and other circulatory problems, these units have been also adapted for the treatment of patients suffering from other types of illnesses and traumatic injuries, who are in critical condition or otherwise require intensive care, treatment and monitoring.
In the typical intensive care units, patients lie on ordinary hospital beds which are equipped with wheels having manually settable brakes, and with side rails slidably attached to the bed frame which may be raised and locked into position to prevent the patient from rolling off the bed. The intensive care unit patient differs from many ordinary hospital patients in that, because of the need for constant monitoring of his or her vital signs and other body functions, he or she is often to be physically linked to, or to be situated in the physical proximity, of numerous monitoring devices, for example, arterial line transducers, transducers, electrocardiographs, temperature monitoring devices or the like. Furthermore, the intensive care unit patient often is connected to one or more intravenous or intra-arterial lines for the administration of nutrients and/or medication, and may also be administered oxygen or other gases, e.g. through a mask placed over his or her face.
In addition to the monitoring and therapeutic devices which an intensive care unit patient may be linked to on a longterm basis, there are other items of equipment which must generally be kept in the proximity of the patient for use in emergency situations, which may occasionally arise. Such emergency equipment includes, for example, intra-arterial balloon pumps (IABP) and defibrillators. These items of emergency equipment are kept in the intensive care unit room but must be wheeled over to the patient's bed when the emergency situation arises and must be brought adjacent to the bed for operative use, frequently among a crowded tangle of other instruments and flow lines linked to the patient.
Moreover, intensive care unit patients are frequently in need of medication administered periodically (such as by parenteral injection) as part of routine therapy or administered in emergency situations. An intensive care unit patient may often be administered several different medications in a single day and the medications normally must be brought over to the patient by a nurse or other health care professional on a hand trolley which must be placed adjacent to the bed and then removed after the medication has been administered.
The conventional hospital bed currently used in most intensive care units is not well adapted for the conditions encountered in such units. Such a bed does not have ordinarily mounting accessories or receptacles for the orderly and space-saving attachment of monitoring devices and flow lines (together with their liquid and gas reservoirs such as bottles, bags or tanks). The known bed also does not accommodate emergency care devices such as defibrillators in a particular designated location or mounting area that health care personnel could immediately turn to and have the correct emergency device at hand when the need arises. Moreover, such a customary bed also does not have associated with it adequate shelf or drawer space for medication, syringes and other supplies such as sponges, alcohol wipes, small monitoring components such as transducers, and the like. The bed of conventional design also generally does not have associated with it portable power sources to supply power to the various electrical instruments which surround the intensive care unit patient.
Intensive care unit patients frequently must be taken out of the intensive care unit area and transported to another area of the hospital, e.g., for diagnostic purposes or for surgery. In such cases, what is conventionally done is to transfer the patient from his or her hospital bed to a wheel-mounted stretcher or gurney, and the patient is then transported to the x-ray room, operating room and so on. Once the patient arrives at the destination area, he or she usually must be transferred once again from the stretcher to the bed or table used in that area. These transfers are very difficult and sometimes quite dangerous as they are often performed with unconscious or semiconscious patients who are being transferred together with intra-arterial and intravenous lines as well as oxygen sources, monitoring transducers and other devices to which they must remain connected. This makes the transfer process extremely cumbersome and time consuming at best and frequently risky to the patient's well-being.
Attempts have been made in the past to modify conventional hospital beds or stretchers to solve some of the abovementioned drawbacks. However, these modified beds were not designed specifically for intensive care units in most instances and do not solve a great majority of the space and convenience defects created by conventionally used beds. For example, in U.S. Pat. No. 2,904,798, a hospital bed with multipurpose equipment is shown which includes a "bed chair" arrangement whereby a back rest is attached to the foot of the bed which can support the patient in a seated position on the mattress; a table mounted on the bed frame at the side of the bed for medication, instrumentation and the like; a slidably mounted drawer under the bed, and an extendable footrest. In U.S. Pat. No. 3,304,116, there is shown a wheeled "carriage" for supporting a patient, which carriage includes such attachments as a fifth wheel located near the center of the undercarriage to prevent drifting of the carriage while moving, a hydraulic height-adjusting mechanism, a side rail which converts into a partial shelf when folded down parallel to the bed surface and brackets for mounting an oxygen tank and a basket for necessary equipment and medications.
The apparatus disclosed shown in U.S. Pat. No. 3,818,516 is specifically designed to facilitate x-ray examinations in order to avoid having to lift and maneuver the patient from a bed to a mobile stretcher and then onto an x-ray table. The bed includes a mattress transparent to x-rays and an extendable upper bed section which may be displaced longitudinally forward from the rest of the bed so that the upper part of the patient's body may be x-rayed with a conventional x-ray apparatus.
Although the above-discussed prior art hospital beds or stretchers are somewhat more useful in an intensive care unit than the conventional hospital bed without accessories, they do very little to solve most of the drawbacks mentioned above. Even combining all of the features of these prior art devices which would be quite difficult because of their great disparate structures, no means would be provided for the space accommodation problem or the monitoring and other devices surrounding the patient, nor for the accomodation of emergency devices, nor for supplying power sources for all the necessary instrumentation. Furthermore, no mounting components are provided in these prior art devices for intravenous and intra-arterial lines, for monitoring transducers for IABP's, and the like.
Recently, certain beds specifically designed for critical care patients, such as intensive care unit patients, have been marketed. The most advanced of such beds includes a built-in hydraulically controlled adjuster for the bed top; a centered fifth wheel to prevent drift and large, carpet castered wheels for better control, particularly at high speeds; an adjustable Fowler panel under the upper portion of the bed mattress which can be actuated to raise the upper portion of the patient's body almost to a sitting position for x-ray and fluoroscopy purposes. This Fowler panel has an x-ray cassette holder built in to facilitate the taking of x-rays right in the bed. In addition, this critical care bed includes a built-in weight monitoring system for in-bed patient weighing and a removable headboard and footboard to gain immediate access to the patient in an emergency. Although this recently introduced critical care bed does embody certain features useful in an intensive care unit setting, it is almost devoid of space/accomodation features such as mounting attachments or instrumentation, intravenous lines, etc. as well as for emergency equipment and does not provide shelf and drawer space for equipment, medication and instruments. Moreover, no internal power source for connection to peripheral instrumentation used in the intensive care unit is provided. Moreover, although the Fowler panel enables the performance of x-ray procedures on the upper portion of the patient's body if the patient can be raised to a near-sitting position, there is no way to x-ray the body of a patient in the prior art bed who must remain in a prone position because the x-ray cassette cannot be inserted into the panel if it is not raised.
In short, no bed or stretcher has been provided in the prior art which is well adapted for use in intensive care units which solves all of the aforementioned problems and drawbacks with conventional and special design prior art beds.